The Oregon Rural Minority Prenatal Nursing Case Management Project is a demonstration and research project involving intensive outreach and public health nursing case management for pregnant Hispanic and Native American women living in three rural Oregon counties. The goal of the project is to improve the birth outcomes of infants born to minority women in the three counties. Birth outcomes for rural Native Americans and Hispanics in Oregon are poor. When compared with urban minorities, the rural Native Americans and Hispanics have significantly higher rates of inadequate prenatal care and low birthweight infants and greater number of high risk babies. The objectives of the project are:1)to empirically identify a workable, effective and efficient nursing model to improve birth outcomes for rural Native American and Hispanic women, 2)to assess the cultural relevance of the Region X Nursing Prenatal Standards for the same population, 3)to identify the self-reported cultural and rural barriers to accessing prenatal services in rural areas for minority women, and 4)to determine cost-benefit ratios for implementation of the nursing model. Intended outcomes of the project will be evaluated using a quasi-experimental design. T-tests will be used to compare pre-intervention with post-intervention birth outcome data. Two by five factorial analysis of variance will be used to determine if mean scores on birth outcomes change over time and differ by minority groups in the expected directions. Rural counties participating in the project will also be compared against fourth non-intervention comparison county on birth outcomes, pre- and post-intervention. Cost benefit analysis will be derived by capturing direct and indirect costs of care to the mother and the infant. Descriptive methods will be used to identify barriers to adequate prenatal care for rural Native American and Hispanic women.